Harada Takahiro, Namera Akira, Nakao Naoki, Murata Kazuhiro, Katsuya Narutaka, Nagao Takafumi, Nagao Masataka
Center for Cause of Death Investigation Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.
Center for Cause of Death Investigation Research, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan; Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.
Leg Med (Tokyo). 2025 Apr;74:102604. doi: 10.1016/j.legalmed.2025.102604. Epub 2025 Feb 27.
Serotonin syndrome has been known as a disease with a potentially life-threatening condition and which occurs usually drug-related and results from an increase in serotonergic activity in the central nervous system. We experienced a fatal case in which may have led to the development of serotonin syndrome and death by intaking privately imported dextromethorphan and moclobemide, MAOIs. We report an autopsy case, a 44-year-old man was found deceased on the bed of his girlfriend's house by her mother. Beside the victim, there was a bottle, which was presumed to have been personally purchased on the Internet, contained two different types of tablets. There were no findings that suggested the presence of obvious trauma or internal diseases in the judicious autopsy. Additional drug testing was performed, and the concentration of dextromethorphan in heart blood was 37.2 μg/mL was detected. In addition, the fact that the patient had a high body temperature and intramuscular bleeding at the time of death strongly suggests that he had died due to serotonin syndrome. In this case, the diagnosis of serotonin syndrome was made on the basis of autopsy findings and additional drug testing. In cases of suspected death due to serotonin syndrome, additional drug testing and quantitative evaluation to identify the causative agent would be helpful in the diagnosis.
血清素综合征是一种可能危及生命的疾病，通常与药物有关，由中枢神经系统血清素能活性增加引起。我们遇到了一例致命病例，患者因私自服用进口右美沙芬和单胺氧化酶抑制剂吗氯贝胺，可能引发了血清素综合征并导致死亡。我们报告一例尸检病例，一名44岁男子被其女友的母亲发现死于女友家中的床上。在受害者旁边有一个瓶子，据推测是在网上个人购买的，里面装有两种不同类型的药片。在细致的尸检中，没有发现明显外伤或内科疾病的迹象。进行了额外的药物检测，检测到心血中右美沙芬的浓度为37.2μg/mL。此外，患者死亡时体温过高和肌肉内出血这一事实强烈表明他死于血清素综合征。在该病例中，血清素综合征的诊断是基于尸检结果和额外的药物检测得出的。在疑似因血清素综合征死亡的病例中，进行额外的药物检测和定量评估以确定病因有助于诊断。
